Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients?

Aims and objectives: To evaluate the training needs and awareness of childhood sexual abuse amongst clinical staff taking cervical screening samples in one inner city primary care trust. Background Studies exploring sexual abuse and nonparticipation in cervical screening have demonstrated that women can experience re-traumatisation if care during examinations is insensitive to their particular needs. Design: This was a mixed methods, service evaluation in three phases. Methods: A literature review, a questionnaire to cervical screening staff in an inner city primary care trust and a focus group of four staff drawn from questionnaire respondents to explore themes raised in the questionnaire data. Results: Data analysis of both quantitative and qualitative data showed that clinical staff underestimated the frequency of childhood sexual abuse although they were aware of the difficulties and reluctance some women experience undergoing gynaecological examinations. When women did disclose childhood sexual abuse or when staff suspected a history of childhood sexual abuse, staff reported feeling unsure of how they should proceed. There was no support or clinical supervision, and unmet training needs were identified. Conclusions: Nurses expressed anxiety around the potential of the screening test to cause more harm than good and at their inability to provide more help than listening. Staff wanted support and further training after completing their cervical screening training course to assist in their provision of sensitive care to patients who have experienced childhood sexual abuse. Relevance to clinical practice: Whilst our results cannot be generalised to a wider population, they may be meaningful for the community of cervical screening takers. We argue that screening staff require further training and professional support (clinical supervision) to increase their confidence when providing safe and sensitive practice for childhood sexual abuse survivors. If staff feel more confident and competent when responding to disclosure of childhood sexual abuse in screening situations, women who have experienced childhood sexual abuse might participate in the screening programme more readily

Assessment in Scotland

Assessment practice will follow and reinforce the curriculum and promote high quality learning and teaching approaches. Assessment of children's and young people's progress and achievement during their broad general education to the end of S3 will be based on teachers' assessment of their knowledge and understanding, skills, attributes and capabilities, as described in the experiences and outcomes across the curriculum

The Workers' Compensation System of British Columbia: Still in Transition

This inventory addresses eight core issues in the British Columbia workers' compensation system:* How is the system administered?* How do claims flow through the system?* What dispute resolution procedures are used, and to what effect?* What benefits are paid?* How are vocational rehabilitation services provided?* How is the system financed?* What are the actual costs of administration, benefits, claims processing, and appeal?* What aspects of the system deserve further attention

The "values journey" of nursing and midwifery students selected using multiple mini interviews; year two findings

Aim: To explore how adult, child, mental health nursing and midwifery students describe their “values journey” after completing their second year following exposure to the clinical practice environment. Background: Where student nurses and midwives are selected using multiple mini interviews, in a values‐based recruitment process, the conservancy and or development of their personal values remains unclear. Design: A hermeneutic, cross‐professional longitudinal study was commenced at one university in England in 2016 with data collection points at the end of years one (DC1), two (DC2) and three (DC3). From the 42 participants recruited in year one, 28 went on to participate in data collection at DC2 (3 adult, 6 child, 3 mental health nurses and 16 midwifery students). Methods: Four semi‐structured focus groups were conducted. Data analysis incorporated inductive and deductive approaches in a hybrid synthesis. Findings: Participants did not feel their values had changed fundamentally since year one. However, the prioritization of their values and how they were “put into practice” had changed. Key themes identified were: “changed sense of self as a healthcare practitioner”; “influences on values in practice” and “reflection on values.” Conclusion: Reframing of personal values is an integral part of learning across clinical and academic settings. Critical reflective practice should be integrated into preregistration health education programmes to support student nurses and midwives sustain their learning around values; to maintain “good” values in the face of observed “bad” values

The 'values journey' of nursing and midwifery students selected using multiple mini interviews: evaluations from a longitudinal study

Values-based practice is deemed essential for healthcare provision world-wide. In England, values-based recruitment methods, such as multiple mini interviews (MMIs), are employed to ensure that healthcare students’ personal values align with the values of the National Health Service (NHS), which focus on compassion and patient-centeredness. However, values cannot be seen as static constructs. They can be positively and negatively influenced by learning and socialisation. We have conceptualised students’ perceptions of their values over the duration of their education programme as a ‘values journey’. The aim of this hermeneutic longitudinal focus group study was to explore the ‘values journey’ of student nurses and midwives, recruited through MMIs, across the three years of their education programme. The study commenced in 2016, with 42 nursing and midwifery students, originally recruited onto their programmes through multiple mini interviews. At the third and final point of data collection, 25 participants remained. Findings indicate that students’ confidence, courage and sense of accountability increased over the three years. However, their values were also shaped by time constraints, emotional experiences and racial discrimination. We argue that adequate psychological support is necessary as healthcare students embark on and progress through their values journey, and propose a framework for this

Cooling of 2 kW H subscript 2-O subscript 2 fuel cell

An extensive research and development program has been carried out to devise an improved method of removing waste heat of reaction from a developmental 2 kW hydrogen-oxygen fuel cell

Preliminary results from the heavy ions in space experiment

The Heavy Ions In Space (HIIS) experiment has two primary objectives: (1) to measure the elemental composition of ultraheavy galactic cosmic rays, beginning in the tin-barium region of the periodic table; and (2) to study heavy ions which arrive at LDEF below the geomagnetic cutoff, either because they are not fully stripped of electrons or because their source is within the magnetosphere. Both of these objectives have practical as well as astrophysical consequences. In particular, the high atomic number of the ultraheavy galactic cosmic rays puts them among the most intensely ionizing particles in Nature. They are therefore capable of upsetting electronic components normally considered immune to such effects. The below cutoff heavy ions are intensely ionizing because of their low velocity. They can be a significant source of microelectronic anomalies in low inclination orbits, where Earth's magnetic field protects satellites from most particles from interplanetary space. The HIIS results will lead to significantly improved estimates of the intensely ionizing radiation environment

Real Estate Income and Value Cycles: A Model of Market Dynamics

We develop a theoretical real estate cycles model linking economic fundamentals to real estate income and value. We estimate and test an econometric model specification, based on the theoretical model, using MSA level data for twenty office markets in the United States. Our major conclusion is that cities that exhibit seemingly different cyclical office market behavior may be statistically characterized by our three-parameter econometric specification. The parameters are MSA-specific amplitude, through the CAP rate, cycle duration (peak-to-peak), via the rate of partial adjustments to changing expectations about stabilized NOI and the market trend.